What do you think is the physician-view of an "ideal patient"? Well, as physicians, though we would like to think of caring for an ideal patient, we have to face the reality that this would rarely happen. You see, the ideal patient would be one who, first of all, bears many of the views and goals of the physician. As physicians, we really can't believe that we will be so lucky. ...

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Does it really make sense for a neurosurgeon to be quoted in a news story about a new treatment for diabetes or prevention of obesity? Some news reporters think so, leaving primary care physicians frustrated at the media’s lack of understanding about the wide range of expertise they practice on a daily basis. In both news and entertainment media, seeking out and representing primary care expertise seems to be the ...

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"Great interview, darling, but there’s one question you didn’t quite answer." My wife is my best coach. She thought the question about a busy orthopedic surgeon not having time to relate to his patients deserved a better response. My interviewer, a psychiatrist, said he once accompanied a surgeon friend on his Saturday morning round of post-op cases. On the drive home, he challenged his friend with the observation that many of the ...

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Those who know and work with me have heard me state without hesitation that it’s morally wrong to do CPR on 90-year old great grandmas. So, it was with great relief that I read the “Do Not Offer CPR” option in a recent JAMA article urging a revision of our present approach to the use of CPR for those who are unarguably at the end of life. This is a change ...

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Always remember why you are a doctorI was recently asked to speak at hematology-oncology Grand Rounds at Rhode Island Hospital. Instead of my usual topics on gynecologic cancers or sexual health, my colleague, MaryAnn Fenton, had asked me to speak to them about promotion in academics. I was both touched and taken aback that I was now in a position to give that kind of advice. ...

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“Cheers!” “To good health,” my girlfriend and I toasted in the living room of our apartment joined by my parents on speakerphone. It had been 12 years since my last radiation treatment—my last treatment for Hodgkin’s Lymphoma. Tonight was the anniversary of my remission, and in the case of Hodgkin’s—a cancer with an exceedingly low relapse rate—tonight was my anniversary of being cured. I kissed my girlfriend goodbye and tread the dark ...

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Pretty much everyone chats up shared decision making these days. And that is good.  It seems intuitive that people (patients) who are knowledgeable about their condition and buy in and/or help to shape the treatment plan are more likely to follow it. Here is an example from my seatmate on today’s flight from SFO to our nation’s capitol. Her son, let’s call him Alex, is a teen with cystic fibrosis (CF). ...

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It's been two days now since I basked in the glory. I still find myself floating above the ground. I can still feel the weight of the heavy gown and the velvet tam. I can feel the tickle of the tassel on my ear. My eyes fill with tears at the thought of my classmates - those who toiled alongside me - experiencing the same emotions. The reminders of our ...

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While reading the New York Times I stumbled upon an article by Pauline Chen addressing issues with doctor patient communication. In the article, Dr. Chen describes a highly educated, articulate patient who was unwilling to speak up and discuss care related issues with her doctor.  The reasons given for not wanting to speak up included not wanting to anger the physician and not giving the perception of questioning judgement. I immediately began ...

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Hurricane season began June 1. And, if you live in a coastal area, you may have an emergency plan. But, have you also prepared your medical information for evacuation? I still remember the difficulty of piecing together the medical histories and treatment plans of Hurricane Katrina victims back in 2005. After our experience with Katrina victims, we understand the need for people to add a simple, one-page form to their evacuation kit. ...

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